Talking about Testicular Cancer

Testicular cancer is cancer of the testes, part of the male reproductive system that makes male hormones (androgens) and sperm, the male cells needed to fertilize a female egg cell to start pregnancy.

The American Cancer Society estimates that in 2019, there will be about 9,560 new cases of testicular cancer diagnosed, as well as 410 deaths from it. They note that testicular cancer is not common; in fact, about 1 of every 250 males will develop testicular cancer at some point in their lifetime.

While it accounts for about one percent of all male cancers, it is the most common form of cancer in young men.

“It is most common in men aged 15 to 40 years and is the most common cancer in men aged 15 to 34, but it can be seen in men of all ages,” explained Diane Bigham, DO, a urologist with Trinity Health.

Symptoms of testicular cancer may include a lump in the testicle or swelling or pain in the scrotum, Dr. Bigham said. The American Cancer Society suggests that some men should examine their testicles monthly, especially if they have a family history of cancer, and the American Urological Association recommends monthly testicular self-examinations for all young men.

Symptoms of testicular cancer can include:

• A lump in one testis, which may or may not be painful

• A sharp pain or a dull ache in the lower abdomen or scrotum

• A feeling often described as “heaviness” in the scrotum

• Firmness of the testicle

• Breast enlargement, or gynecomastia, from hormonal effects of human chorionic gonadotropin (βhCG), a hormone produced during pregnancy

• Low back pain, or lumbago, due to the cancer spreading to the lymph nodes along the back

Mayo Clinic suggests seeing a provider if you detect any pain, swelling, or lumps in your testicles or groin area, especially if these signs and symptoms last longer than two weeks. “If there is any change on a man’s self-exams, a new mass or lump, or any of the above findings, they should call for an appointment as immediately as possible,” Dr. Bigham said. “They will need a urologist to evaluate a mass.”

From there, she explained, a diagnosis is typically based on a physical exam, ultrasound, and blood tests; sometimes, a CT scan is needed.

“Surgical removal of the testicle with examination under a microscope is then done to determine the type. Future management depends on the type and stage of the cancer, with the results of tests,” Dr. Bigham said.